Oak Ridge Reservation: Public Health Assessment Work Group

Public Health Assessment Work Group

March 18, 2002 - Meeting Minutes

Agenda

1. Review of minutes (10 min) - Bob Craig
   
2. Update on PHA and ATSADR issues (10 min) - Jack Hanley
   
3. Videotape on beryllium (30 min) - James Lewis
   
4. Needs assessment for DOE worker medical surveillance
   (10 min) - James Lewis
   
5. Screening maps (30 min) - Bob Craig
   
6. New business (10 min) - Bob Craig

Attendees:

Gordon Blaylock
Bob Craig
Bob Eklund
Karen Galloway
George Gartseff
Jack Hanley, ATSDR (phone)
David Johnson
Timothy Joseph, DOE
James Lewis
Pete Malmquist
L.C. Manley
Bill Murray, ATSDR

Unfinished Business

Pete Malmquist made a motion to approve minutes of the PHAWG Meeting on January 7, 2002. Bob Eklund seconded. All in favor, none opposed. Minutes were approved.

David Johnson made a motion to approve minutes of the PHAWG Meeting on February 4, 2002. Bob Eklund seconded. All in favor, none opposed. Minutes were approved.

Bill Murray will submit draft minutes of the PHAWG Meeting on February 19, 2002, by our next PHAWG Meeting.

Update on Issues Regarding Public Health Assessment (Jack Hanley)

1. We developed a Work Plan originally with Al Brooks. Jack thinks it may be time that he takes another look at it and modify it now that we’ve been around for a year.
   
2. We have a flow diagram. We have made progress on the screening, contaminants of concern, epidemiology.
   
3. First year was about getting everybody “on board” and familiar with ATSDR’s PHA process and the methodologies. This took time, but the intended result is that, in the near future when we’re it comes time to make these PHA decisions, the Subcommittee and the Work Group members can help ATSDR make effective decisions for this area.
   
4. One great hurdle that we’ve already cleared: the Work Group and Subcommittee reviewed, discussed, and adopted the use of the State of Tennessee screening process to identify contaminants of concern (COC). Now we need to make progress and move forward on each of the individual COCs.
   
5. Another thing that was instrumental was addressing issues/concerns that were brought to the table in writing. We had to develop methods of communicating what are findings were and also making sure that we clearly addressed those concerns. We did that with the screening process. He hopes that the Work Group will continue to develop and use the process that James Lewis developed so that we continue to collect, document, and address concerns. That will be the key to making progress.
   
6. Thanks to Lucy Piepins, most of us now have some understanding of the skills needed to review scientific reports. The critiquing exercise was helpful. Jack would like to have those types of activities in the near future with some of the outstanding issues.
   
7. Came up with the initial list of COCs. There could be other issues or specific contaminants that come up.
   
8. Jack’s goal over the next 6-8 months is to go over iodine and uranium and some of the individual COCs with the mapping that the PHAWG is looking for. In future PHAWG meetings, we need to lay out a strategy to cover outstanding issues on these.
   
9. Regarding iodine: We’ve had a site visit, and some excellent technical presentations that were comprehensive on the issues. We may need to refamiliarize ourselves on some of these issues since it’s been a while since we’ve heard them. One big issue is whether we should combine iodine doses. Now that Paul Charp is on board, the Work Group should look at this again. Jack needs to know the Work Group’s position on combining doses. Jack and Paul are going to work together to lay out the carcinogenic and non-carcinogenic effects of iodine. Paul will be talking about the 5-rem issue. They will also be trying to determine the geographic regions that need to be looked at more closely.
   
10. The Work Group and Subcommittee did address the source term issues; they’re almost finalized.
    
11. Regarding uranium: Jack would like to lay out a strategy, maybe in the next PHAWG meeting, to get uranium evaluated, get the concerns collected, and make some headway on uranium. Bob Craig asked Jack to give PHAWG an overview of what ATSDR’s conclusions are and what health effects of uranium are, and of the different isotope concentrations of it. We understand the relative threat or risk of depleted uranium vs enriched uranium. That deals with K-25 and Y-12. They were really quite different. Jack said we’ll likely have to take those in different meetings and break them out, and Jack will develop a strategy for the Work Group. Bob Craig stated that all uranium was just plastered as “uranium” and it really is so completely different.

Bob Craig: Jack, you need us to make a decision for you on are we going to combine the dose from the atmospheric testing? Is that right?

Jack Hanley: That was an outstanding issues for the Work Group last year. The presentations we’ve had by Owen Hoffman, Tom Widner, and Charles Miller lay out many of the issues. It may take someone sitting down and reviewing those presentations, looking at the minutes, summarizing it for the Work Group. The Work Group has to deal with that issue. That issues still seems to be churning. We (ATSDR) would like to get your position on it.

Pete Malmquist: After listening to all the speakers, to my mind, there was an exposure. I can’t remember which speaker - when we asked him if his daughter was exposed, what would you do? He said I would inform her, and then tell her to go to her health professional and be sure and be checked for that. In my mind, what difference does it make whether the exposure was 2 or 10? If you’re exposed, that person should be told, and go to their health professional and the health professional does it. Doesn’t matter to me what the dose was. They were exposed - whether it’s small or large - what difference does it make?

Jack Hanley: There are doses where you would say it is definitely not a problem.

Pete Malmquist: I agree, but I’m talking about those people in the area that have been exposed, and they are exposed, say, over here in Bradbury.

Jack Hanley: In areas where we know they’re at levels of health concern or at levels where we’re not quite sure. That’s what we’d like to lay out - some kind of way geographically to show those areas. There are other areas where dose was so low that you don’t have any concerns, and we need to make that clear for those folks.

Pete Malmquist: I agree - if you go north from here to Wartburg, there’s probably no concern. But I think we’d be spinning our wheels sitting here talking about doses, rather than geographic areas where people would be exposed.

Bob Craig: As I see it, you’re going to be able to delineate (using quite conservative estimates) areas that could have received doses where you might see an effect. Is that correct? You’re going to delineate those geographical regions? (Jack’s response: Yes.) I think what I’d like to see is what compounding factor does the atmospheric testing put on that area as far as: what percent does that raise it, or does it then raise some other areas that would not have been considered. And from the way I understand Owen’s calculator, it’s a very simple thing to do - you just plug in where you are and it tells you what the atmospheric dose was. Right? It may be a simple thing to do. So that you guys can be looking at what the impact is from the Reservation, and we can turn the switch on and say “and here’s what the atmospheric (testing) may have contributed over and above that.”

Jack Hanley: That’s something I’d have to talk with Paul Charp, the health physicist, about. But that kind of discussion needs to go on in the Work Group.

Bob Craig: Right, and that’s what I need to do. But the atmospheric testing is not trivial as far as the iodine dose during that period.

James Lewis: The question is “should we combine doses?” In last meeting we had (it wasn’t in this group), we even talked about combining some of the TVA efforts. I think when we look at this, even though we look at iodine, we need to look at some of the generic logic that we’re talking about and where we’re going with this. Are we vs should we combine doses. What does that do to our program or charter?

Bob Craig: Yes, again, if we’re not just looking at the Reservation . . .

Jack Hanley asked if there is someone who can take this issue on to relook at videos, take notes, and refresh everyone on this issue as James did in the past on other issues. Kowetha Davidson was thinking of doing it last year, but not sure if that’s the case now. Someone will talk to her and see if she still plans to do it.

Bob Eklund had a comment about combining doses. I agree that, in one sense, we’re just looking at the Reservation. But what we’re really doing is looking at health of public within the area of the Reservation, or within the area that might have been affected by the Reservation. Since we’re looking at the health of those people, we have to take into account whatever affected their health, whether it was due to the Reservation or not.

Bob Craig: This case is kind of a baseline dose that you’re getting from atmospheric testing, and the dose added to that from RaLa processing during those years. I do see your point, Bob. It would be kind of neat to look at what we’re getting in excess now and then. Atmospheric testing was a very short period of time, too; it was actually bursts.

Bob Eklund: But we need to distinguish between what is so small that it’s insignificant and what is significant. And if atmospheric testing is a significant thing to add in, we should add it in if we’re trying to consider the effect on the health of the people.

Bill Murray: Just to make a point, from what I remember from Charlie Miller’s talk, Charlie said that combining doses was not necessarily a straightforward thing to do. He would it would require additional work, and he would need some funding to address the problem because it just wasn’t something you could do with an off-the-shelf type of approach.

Bob Craig: That’s where I was mistaken. I thought that Owen Hoffman had an on-line calculator where you put in your specific location and he read out your dose.

James Lewis: He demonstrated that I know in Scarboro - in the community - he showed that. As far as Bob’s comment, I don’t know if this thing has to be looked at in two phases. One is, what was the impact of the Reservation. Then you may come back and say, if you combine these things, what do they look at. But I think some kind of logic needs to be laid out here to . . .

Jack Hanley asked Bill Murray if there was a report recently about all these releases from weapons testing, etc, that Charlie Miller and all were working on. Bill Murray responded saying that it was some testimony that he say recently, and he doesn’t know that he saw anything more than that. Jack said a number of things are going on now and it all needs to be brought together.

James Lewis: CNN had a number of reports either last week or two weeks ago in which they were talking about this issue and the number of deaths that may have been created . . .

Bob Craig: Yeah, I saw that - 15,000 people killed by cancers . . .

James Lewis: . . . and they made reference to a report that was out, and I remember that we went on the internet and chased one reference - the New York Times had a spin on it, and I think they referenced Charlie Miller’s name if I remember right. Some of the other papers didn’t. But wherever this document is, I think it is something worthy of us getting a copy and reviewing it.

Bob Craig said he downloaded the report and has it on his desk.

L.C. Manley: I don’t remember the details, but Senator Harkins was giving a spill about same thing just a couple of days ago.

Bob Craig: Jack, you’re thinking that we should look for volunteers among this group for someone to go back and pull the data together?

Jack Hanley: Yes, to look at what has been talked about (key points) and bring them back to the table and summarize them. Just take it apart like James has on a number of other issues. That method has been helpful in the past. I’ll be glad to work with whoever this is.

James Lewis: I think Kowetha sort of gave the indication (we need to find the minutes or tape) . . . we need to find out from her where she stands and who wants to help her with it. If she doesn’t remember that, . . .

Bob Craig: Shall I call Kowetha? James Lewis responded that would be his recommendation.

ACTION ITEM FOR BOB CRAIG: E-mail Kowetha on review of additive doses on iodine. This would involve looking at the tapes, looking at the new report, talking to Paul Charp, and produce an overview/refresher for Work Group.

James Lewis: In addition to this, we hear “synergistic effect.” This is not a simple issue. We really need to look at this in light of what are we chartered to do, what do we do if we do if we combine this and we head toward the synergistic effect. These are three different steps.

Bob Craig: Synergism is a little bit of a different animal. We know a lot more about additive doses than we do about synergism. Also, the work we see on synergism seems to indicate that the dominant contaminants seem to act almost independently - that there isn’t a whole lot of interactive effect (or maybe additive). Additive doses in this case, where it’s the same isotope, and we know where it hit and when it hit, and how much of it decayed and that kind of thing . . . Okay, Jack, we’ll do that.

Bob Craig: Jack, are you looking to have iodine and uranium finished in the next 4-5 months?

Jack Hanley: Yes, I’m shooting to have them done by the end of the fiscal year (end of September).

Bob Craig: We had talked about iodine in the December-January time period for a draft. Do you have a timeline now for iodine?

Jack Hanley: I’ve been trying to bring Paul Charp up to speed and get him involved. I’m thinking maybe at the next Work Group meeting, we can lay out a time table and what his expectations are to get it done.

Bob Craig: So we’ll get this on the agenda of next PHAWG meeting, Bill, to talk about a time table. Bill Murray responded yes.

Bob Craig agreed to keep the “Status Update” as a standard topic on each PHAWG Meeting agenda so Jack can keep the Work Group apprized of what is needed to proceed with the PHA.

Presentation on Beryllium (James Lewis)

This is a rehash of what was presented to Needs Assessment Work Group. He’s primarily presenting the PACE Program which cares for the gaseous diffusion workers here in Oak Ridge. The key here is that we’re moving from what they define as the Phase I project to the Phase II (where clinical intervention takes place). Right before you go to clinical intervention, there is a Needs Assessment.

James basically compared the Needs Assessments of the PACE Program to the one we’re working on, and highlights the similarities and differences between the two. Both Needs Assessments utilize ChemRisk dose reconstruction data. The PACE Program is able to utilize DOE’s actual dosimetry data on individuals, whereas in the ORRHES effort, we would not have individual dosimetry data. Both efforts have similar methods used. Both programs employ exposure assessments. PACE uses “risk mapping;” we utilize telephone surveys and focus groups from the communities to gather concerns to complete a similar task.

PACE completed their evaluation of the releases and exposure assessments prior to identifying what remedial actions and/or clinical actions that should be taken. One key point: PACE emphasized the need to complete the evaluations and exposure assessments RAPIDLY as people lose interest very quickly. ORRHES/ATSDR now has the “clinic” issue on the table and discussions are ongoing. Jack Hanley’s timeline should help us keep on task.

PACE has actual recommendations, but we’re not there yet. We may have potential recommended actions, but we really cannot decide that for sure until all these other steps are completed (including whatever decision we make regarding combining doses, whatever information we receive back from Dr. Jackson, etc.).

Another point: The people who will be coming to give presentations at the next Subcommittee meeting will focus on PACE, but will also give similar rolldowns of other programs all over the country.

Mapping (Bob Craig)

Bill Murray passed around colored maps from OREIS indicating where sampling has been done - one map for each type of sampling media (air, biota, water, etc.). Bill said John Merkle put these maps together. Chudi Nwangwa (Tennessee Department of Environment and Conservation (TDEC) - DOE Oversight Office) generated them. The show locations of all sampling relative to the source term (DOE Facilities).

Pete Malmquist: How far downstream did you do water sampling?

Bob Craig: Nobody here did it. I don’t think anybody knows. Tim Joseph may be the only one to answer that. Oh, there are cesium samples all the way down past Chattanooga.

Pete Malmquist: I know that they took milk samples all over the area.

James Lewis: Maybe you need to frame this regarding what happened in the last meeting. Susan and John Merkle talked about this issue.

Bob Craig: And he stopped by their (TDEC’s) office, and they said they could spin those off in nothing flat.

James Lewis: And they had a vote that they wanted to pull maps in the Work Group, and he went to TDEC and I think this is what was extracted.

Bob Craig: Then I think we ought to postpone whatever we’re going to do on this until Susan is here. She was certainly the most concerned. And John Merkle is not here either.

James Lewis: But we don’t get a lot of people to visit the office, so I think we ought to review this. The question I have is what is the value-add of this. I had some experiences with DOE on another project (Scarboro). Tim was so gracious to bring us copies of a report he put out based on my request from Scarboro. I’m going to make this part of the record, and put copies in this office. It tells the history of an effort that went on in Scarboro in which certain maps were presented and laid out, the reaction that we got associated with those maps. It was very difficult for us to recover because when the public observed the issue and saw the maps, they felt like they had been shortchanged for some reason or another. Nobody was able to recover. There’s a section in here that I think we could get a . . .

Bob Craig: But I don’t think these would cause any controversy with folks. But it is kind of good to see where they have taken them. Now as I understand it these are only the ones at ORNL, which means they are since 1990. Obviously, there were a lot of samples taken prior to that time.

James Lewis: You used the term “controversy.” We had a major problem because somebody took a section of a map that had blocked out Scarboro on a flyover. That was presented to the entire community. The impression that they got from that was that they had been ignored. Then the next thing we knew there was a whole lot of . . . Mr. Manley can explain it better . . . we do have a videotape and if we can work it in, you can see the history of what happened as associated with that. I asked Tim to put together a history of it because we lost sight of what the man that was there was presenting. He tried to explain to the people what had gone on to give them a historical timeline. We lost all of that. Next thing we knew, they were flying over again, we had people out there digging soil samples up, and this has been 3 ½ years to the best of my knowledge, and we still don’t have an answer. We may have other communities requesting the same thing. My point to you is this: People can do what they want to do, you can look at data. But I’d like to share with you at next meeting a historical perspective of what happened with something similar to this if it’s not presented in the right context so everybody has an understanding. It may take a series of these (maps). These don’t indicate what you found; they don’t know when you did it.

Bob Eklund: What chemicals were tested for/found?

Bob Craig: They don’t know that yet. These are analyses by media. We don’t have hits yet. I can see a lot of samples that I took that aren’t on here - plutonium in crayfish in White Oak Lake. That was back in the 1970s, and I don’t think we got into that.

Pete Malmquist: If you look at sampling locations, there’s a logical thing all the way downstream to the dam. They took sediment samples all the way across the lake - all the way down.

Bob Craig: Not core samples, but sediment samples? My recollection is that they only took 5 or 6 core samples because those things are darned expensive ($20K a pop).

James Lewis: Right behind you is a map that shows the various homes in Scarboro. Take a look and see the where they sampled, as far as which plots of land. On that wall is the arial photo of Scarboro. If I bring you the videotape and you watch the responses to this, you’re going to see responses like “you tested Ms. So-and-So’s yard, but you didn’t get one from my yard. I’ve lived here for 15 years and I live next to the fence . . .” Sometimes trying to explain sampling to the community . . .

Bob Craig: This is for us, though, and we are a little bit different than the community, I think. We’ve got a couple of upstream samples, and quite a few downstream as I see it. We have soil, air, biota, water, etc. Most were taken in the proximity of where source term is.

Bob Eklund: When you say source term, do you mean where the iodine was coming from, or the uranium was coming from, or the mercury?

Bob Craig: Right. And it’s right here around the plants. This is Bear Creek and straight down Bear Creek. Bear Creek was pretty contaminated from those 3 ponds until they cleaned that up. You can also see that Bear Creek’s a long way from getting offsite.

Pete Malmquist: The cesium burial was over in this area by Jones Island, and here’s all the sampling down below it.

Bob Craig: Right. And it’s quite a bit. But that’s where it’s coming from.

James Lewis: Are those maps comprehensive of (all testing): DOE, TDEC, EPA, etc.?

Bob Craig: These are from OREIS, and I believe that these are only since 1990, and I’m not sure whether it’s . . .

Gordon Blaylock: Probably, some things go back further than others, but I’d have to know exactly what you’re asking as far as what sampling, but I think it goes back further than 1990.

Bob Craig: Gordon Blaylock was the guy who did the sampling. He was out there every morning in his rubber boots.

James Lewis: Is this what Susan asked for?

Bob Eklund: This is part of it.

Bob Craig: I thought this was pretty much it.

Bob Eklund: It doesn’t tell what they were trying to find - what did they test for?

Bob Craig: I thought that we kind of waved that off - that she just wanted to see where the samples were taken by media.

Bill Murray: Her recommendation reads, “The PHAWG recommends to ORRHES that they urge ATSDR to expedite the generation of maps, in color, showing where all soil, water, and air sampling was done for each contaminant of concern as soon as possible because of the importance to the credibility of the Public Health Assessment.” It doesn’t say anything about results, and I sent this to her, and these have her corrections in it.

Bob Craig: I specifically remember discussing results, and she said no, I just want to know where they were taken, by media.

Tim Joseph: They don’t have contaminants of concern as I heard him say.

Bob Eklund: That’s a key element.

Bill Murray: She wanted them for each contaminant of concern.

Bob Craig: That could be a whole lot more data, a whole lot more information.

Bill Murray: We’d have to have maps for every one.

Pete Malmquist: If we take soil samples, and you have 15 different contaminants you’re looking for, you’d have to have 15 different maps to show what they did for each one.

Bill Murray: You’d have to have multiple maps for contaminants.

Bob Eklund: If you had a map of soil samples and they were all tested for everything, you could say what they were tested for and use that one set of maps when you talk about a particular contaminant.

Pete Malmquist: We don’t know how many contaminants did they check per sample.

Bob Eklund: That’s the million dollar question.

Bob Craig: I don’t know. We can probably get that.

Pete Malmquist: When they took a soil sample, would they not have checked for a whole spectrum of contaminants?

Bob Craig: I would bet that there would be certain things that they would get a hit from almost all samples. There would be other things they would get in very, very few samples.

In looking at the soil sampling map, Bob Eklund asked why they took samples in Morgan County. Bob Craig said they were used as background samples.

Bob Craig: John Merkle thought this (maps) hit everything he wanted to see.

James Lewis asked everyone to look at Table 1 (flyover information). Where you see a “no” on this table, because of the community reaction, we ended up doing another flyover and samples taken from those sites.

Tim Joseph: The flyover in 1992 caused more problems because it looked like they intentionally left off a chunk of Scarboro when it was intended to be a focused survey. They hit 1/3 of Scarboro because they were doing the creek.

New Business:

Bill Murray reminded everyone that two recommendations from the last meeting will be going to ORRHES. We need to make sure we’re on the same page about those.

The first one is about not sending the letter to Dr. Henry Falk regarding the need for public availability of the references/interviews for the Oak Ridge Dose Reconstruction in light what we have learned about the availability of these references from Dr. Timothy Joseph. Everyone agreed this one is okay.

The second one urges ATSDR to generate maps in color showing where all soil, water, and air sampling was done for each COC. The difference between what we now have and what we’re requesting is the wording “for each COC” plus periodicity (when they were taken).

There was some discussion about briefing Chudi Nwangwa before the ORRHES meeting so that he can be prepared to give more details.

James Lewis said the request is going to ATSDR, not TDEC. So he will have to decide whether this will be a combination of maps from various sources, etc. We need to keep a central focal point.

Bob Craig said they’re just trying to give Chudi a heads-up.

Bob Eklund said it’s not really Jack’s job until it goes through ORRHES. If, before that, we find out that the information is already here (like has already happened in Recommendation #1), we wouldn’t need to ask.

Bill Murray will give Chudi a quick heads-up, and we’ll be ready to respond.

Everyone finally agreed that the second recommendation is okay.

Jack talked about the beryllium video. He sent it for us to view because it gives the historical context of beryllium, what the standards were then and now, the DOE’s efforts that have gone into this program. Beryllium is a contaminant where there was a clear source, pathway, exposures, health effects, and DOE has taken action to protect the people.

BERYLLIUM VIDEOTAPE WAS SHOWN.

Bob Craig scheduled the next PHAWG meeting: April 1, 2002 @ 5:30 p.m. in the Oak Ridge ATSDR Field Office.

Bob Craig adjourned the meeting at 7:20 p.m.